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Idaho rates for HCPCS A4422

Ostomy absorbent material (sheet/pad/crystal packet) for use in ostomy pouch to thicken liquid stomal output, each

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.09 / $0.22 / $0.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.09 / $0.09 / $0.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.08 / $0.08 / $0.11
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$0.05 / $0.12 / $0.22
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.14 / $0.14 / $0.16
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.15 / $30.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.11 / $0.11 / $0.16
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.06 / $0.07 / $0.12